Inflammation MCQs

A 22-year-old man develops marked right lower quadrant abdominal pain over the .١
past day. On physical examination there is rebound tenderness on palpation over
the right lower quadrant. Laparoscopic surgery is performed, and the appendix is
swollen, erythematous, and partly covered by a yellowish exudate. It is removed,
and a microscopic section shows infiltration with numerous neutrophils. The pain
experienced by this patient is predominantly the result of the formation of which of
‫؟‬the following two chemical mediators

a) Complement C3b and IgG

b) Interleukin-1 and tumor necrosis factor

c) Histamine and serotonin

d) Prostaglandin and bradykinin

e) Leukotriene and HPETE

A 40-year-old woman had bilateral silicone breast implants placed two years ago. .٢
Since that time, she has noted increased firmness with slight deformity of the
breast on the left. The implants are removed, and there is evidence for leakage of
the implant contents on the left. Which of the following cell types is most likely to
‫؟‬be most characteristic of the inflammatory response in this situation

a) Mast cell

b) Eosinophil

c) Giant cell

d) Neutrophil

e) Plasma cell

A clinical study is performed of patients with pharyngeal infections. The most .٣

typical clinical course averages 3 days from the time of onset until the patient sees
the physician. Most of these patients experienced fever and chills. On physical
examination, the most common finding is a pharyngeal purulent exudate. Which of
‫؟‬the following types of inflammation did these patients most likely have

a) Granulomatous inflammation

b) Acute inflammation
c) Abscess formation

d) Resolution of inflammation

e) Chronic inflammation

A 20-year-old man has experienced painful urination for 4 days following spring .٤
break. A urethritis is suspected, and Neisseria gonorrheae is cultured. Numerous
neutrophils are present in a smear of the exudate from the penile urethra. These
neutrophils are most likely to have been caused to undergo diapedesis to reach the
organisms as a consequence of release of which of the following chemical
‫؟‬mediators

a) Histamine

b) Prostaglandin

c) Hageman factor

d) Bradykinin

e) Complement C5a

.٥
A 90-year-old woman has developed a fever and cough over the past 2 days.
Staphylococcus aureus is cultured from her sputum. She receives a course of
antibiotic therapy. Two weeks later she no longer has a productive cough, but she
still has a fever. A chest radiograph reveals a 3 cm rounded density in the right
lower lobe whose liquefied contents form a central air-fluid level. There are no
surrounding infiltrates. Which of the following is the best description for this
‫؟‬outcome of her pneumonia

a) Hypertrophic scar

b) Abscess formation

c) Regeneration

d) Bronchogenic carcinoma

e) Progression to chronic inflammation

A 35-year-old woman has been taking acetylsalicylic acid (aspirin) for arthritis for .٦
the past 4 years. Her joint pain is temporarily reduced via this therapy. However,
radiographs of her knees reveals continuing joint destruction with loss of articular
cartilage and joint space narrowing. This pain reduction is most likely to be the
‫؟‬result of diminishing which of the following inflammatory responses
a) Neutrophil chemotaxis by leukotriene B4

b) Fever resulting from interleukin-1 release

c) Prostaglandin-mediated vasodilation

d) Pain resulting from bradykinin generation

e) Anticoagulation by Hageman factor inhibition

A 37-year-old man has had nausea and vomiting for 5 weeks. He experienced an .٧
episode of hematemesis yesterday. On physical examination he has no abnormal
findings. Upper GI endoscopy is performed, and there is a 1.5 cm diameter lesion in
the gastric antrum which appears to be an area with loss of the epithelial surface.
‫؟‬These findings are most typical for which of the following pathologic processes

a) Abscess

b) Serositis

c) Granuloma

d) Gangrene

e) Ulcer

A 15-year-old girl has had episodes of sneezing with watery eyes and runny nose .٨
for the past 2 weeks. On physical examination she has red, swollen nasal mucosal
surfaces. She has had similar episodes each Spring and Summer when the amount
of ragweed pollen in the air is high. Her symptoms are most likely to be mediated by
‫؟‬the release of which of the following chemical mediators

a) Complement C3b

(b) Platelet activating factor (PAF

(c) Tumor necrosis factor (TNF

d) Histamine

e) Immunoglobulin G

MCQs on Inflammation & Healing

A 65 year old man developed myocardial infarction in the posterior wall of the left .١
ventricle. Which of the following pathologic findings would most likely be seen in
‫؟‬the left ventricle 1 month later

a)Abscess

b)Complete resolution

c)Coagulative necrosis

d)Fibrous scar

An experiment infects one group of test animals with viral hepatitis. Two months .٢
later, complete recovery of the liver architecture is observed when the livers are
examined microscopically. A second test group is infected with bacterial organisms
and after the same period of time, fibrous scars from resolving abscesses are seen
microscopically in the liver. Which of the following factors best explains the
‫؟‬different outcomes for the 2 test groups

a) Extent of liver cell injury

b) Injury to the connective tissue framework

c) Location of the lesion

d) Extent of damage of bile ducts

Which of the following terms best describes: a nodular raised scar that .٣
‫؟‬developed at the suture site over 2 months

a) Organization

b) Resolution

c) Keloid formation

d) Secondary union
‫؟‬Which of the following statements best describes the wound site after 1 week .٤

a) Granulation tissue is still present

b) Collagen degradation exceeds synthesis

c) Wound strength is 90% of normal tissue

d) Neutrophils infiltrate the margin and the wound is filled with blood clot

A 70 year old man died of congestive heart failure 2 weeks after an acute .٥
myocardial infarction. On postmortem examination the necrotic myocardium has
largely been replaced by capillaries, fibroblast, and collagen. Various inflammatory
cells are present. Which of the following inflammatory cell types in this lesion that
‫؟‬plays the most important role in the healing process

a) Macrophage d) Eosinophil

b) Plasma cell

c) Neutrophil e) Lymphocyte

A 40 year old woman had mid epigastric abdominal pain for the past 3 months. .٦
An upper gastrointestinal endoscopy showed a 2 cm. sharply demarcated shallow
ulceration of the gastric antrum. A biopsy specimen of the ulcer base revealed
angiogenesis, fibrosis, mononuclear inflammatory cell infiltrate with lymphocytes,
macrophages, and plasma cells. Which of the following terms best describes this
‫؟‬pathologic process

a)Acute inflammation d) Fibrinous inflammation

b)Chronic inflammation e) Granulomatous inflammation

c) Serous inflammation
One month after appendicectomy, an 18 year old young man palpates a small .٧
nodule beneath the skin at the site of the healed incision. Microscopic examination
of the removed nodule revealed macrophages, collagen, few small lymphocytes,
multinucleated giant cells and refractile material. Which of the following
‫؟‬complication of the surgery is the cause of the nodule

a) Chronic inflammation d) Ulceration

b) Abscess formation e) Fistula formation

c) Suture granuloma

A 5 year old child had erythematous skin of the fingers with small blisters after .٨
he has touched a pot of boiling water over the stove. Which of the following best
‫؟‬describes the process

a) Fibrinous inflammation

b) Suppurative inflammation

c) Serous inflammation

d) Catarrhal inflammation

An 80 year old woman was diagnosed as having Staphylococcal pneumonia and .٩

received a course of antibiotic. Two weeks later, she no longer had productive
cough but she is still feverish. A chest X ray revealed a rounded 3 cm. mass in the
lower lobe of the right lung that has a central air- fluid level, and no surrounding
infiltrates. Which of the following terms best describes the sequel of the patient’s
‫؟‬pneumonia

a) Complete resolution

b) Fibrosis

c) Abscess formation
d) Progression to chronic inflammation

‫؟‬Which of the following statements best describes the wound site after 1 day .١٠

a) Granulation tissue is still present

b) Collagen deposition & fibroblast proliferation are present

.c) Scar consists of connective tissue devoid of inflammation

d) Neutrophils infiltrate the margin and the wound is filled with blood clot

‫؟‬Which of the following statements best describes the wound site after 2 months .١١

a) Granulation tissue is still present

.b) Collagen deposition & fibroblast proliferation are present

.c) Scar consists of connective tissue devoid of inflammation

d) Neutrophils infiltrate the margin and the wound is filled with blood clot

Which of the following terms best describes: a type of repair in which the .١٢
‫؟‬damaged tissue is replaced by granulation tissue then fibrous tissue

a) Organization

b) Resolution

c) Keloid formation

d) Secondary union

Which of the following terms best describes: excessive amount of granulation .١٣
‫؟‬tissue, which protrude above the level of the surrounding skin
a) Organization

b) Resolution

c) Keloid formation

d) Proud flesh

INFLAMMATION

Dr. SANAA SAMMOUR

:SHORT QUESTIONS

‫؟‬What are the reactive changes of acute inflammation(١)

Define chemotaxis(٢)

.Mention three chemical mediators of inflammation and their producing cells(٣)

Mention the pathogenesis of the inflammatory exudate(٤)

‫؟‬What are the functions of the inflammatory exudate(٥)

…………………………… The inflammatory exudate consists of(٦)

………………… …………………………………………

‫؟‬What are local signs of acute inflammation(٧)

‫؟‬What are the systemic changes in acute inflammation(٨)

‫؟‬What is the fate of acute inflammation(٩)

.Mention types of acute non suppurative inflammation with examples(١٠)

...………The pseudomembrane of membranous inflammation consists of(١١)

...………………………………… …………………………………………

.…………… …………………………………………The pus consists of(١٢)

..…………………………………The abscess consists microscopically of(١٣)

..……………………………… …………………………………………

.Mention complications of an abscess(١٤)

.Mention examples of localized suppurative inflammation(١٥)

Give a short account on carbuncle(١٦)

Mention 5 differences between acute and chronic inflammation(١٧)

:LONG QUESTIONS

.Discuss the reactive changes of inflammation(١)

..Discuss the types of acute non suppurative inflammation(٢)

.Give an account on acute suppurative inflammation(٣)

Discuss the pathology of the abscess; definition; pathogenesis, structure and (٤)
.complications

..Mention the differences between acute and chronic inflammation(٥)

HEALING
:SHORT QUESTIONS

.What are the types of healing, and define each type with examples(١)

Give an account on healing by resolution, definition, its features, mechanism and (٢)
.give an example

What are the types of cells according to the power of proliferation and give an (٣)
.example of each one

. Define healing by regeneration(٤)

What are the main components of headlining by regeneration and mention the (٥)
.probable mechanisms
What are the probable mechanisms of healing by regeneration and factors (٦)
affecting it

.……………… ………………………………………CHALONES are(٧)

..…………………… …………………………………………

‫؟‬What are the roles of growth stimulating factors in healing by regeneration(٨)

.Define healing by organization and give three examples(٩)

.Describe gross and microscopic picture of granulation tissue and its fate(١٠)

‫؟‬What is the function of growth factors in healing by organization(١١)

.Mention the steps of wound healing by first intention(١٢)

.Describe healing by second intension and mention examples associated with it (١٣)

.Mention 5 differences between healing by first and second intension(١٤)

.Mention 4 complications of wound healing(١٥)

.Mention factors influencing wound healing by organization(١٦)

.Describe healing of mucous membrane of the gastrointestinal tract (١٧)

.Describe healing of liver or kidney(١٨)

.Mention steps of bone repair(١٩)

.Mention four causes of delayed union of a bone fracture(٢٠)

‫؟‬What are the factors responsible of non union of a bone fracture(٢١)

Describe healing of a brain infarct(٢٢)

Describe healing of a peripheral nerve damage(٢٣)

:LONG QUESTIONS

Discuss healing by regeneration; definition, mechanism and factors influencing (١)

.it

.Discuss healing by organization(٢)

Discuss wound healing by first intension(٣)
.Describe repair of a bone fracture and mention its complications(٣)

BACTERIAL INFECTION
:SHORT QUESTIONS

.Mention ways of spread of infection(١)

.How local spread of infection occur to the surrounding tissue(٢)

.…………… ………………………………………Septicaemia means(٣)

……………………………… …………………………………………

.……………… ………………………………………Pyaemia means(٤)

……………………………… …………………………………………

Mention 4 effects of acute toxaemia(٥)

.Mention 4 differences between exotoxins and endotoxins(٦)

.Mention 3 effects of chronic toxemia(٧)

‫؟‬What are the effects of bacteraemia(٨)

Mention 4 pathological features of septicaemia(٩)

.Describe gross and microscopic picture of septicaemic spleen(١٠)

.Mention types of pyaemia with 2 examples of each type(١١)

.Describe microscopic picture of pyaemic abscesses (١٢)

.Define pyaemia and mention its pathogenesis(١٣)

:LONEG QUESTIONS

.Give an account on septicaemia (١)

Give an account on pyaemia(٢)

CELL INJURY
:SHORT QUESTIONS

Discuss pathogenesis of cell injury(١)

‫؟‬What are the forms of reversible cell injury(٢)

‫؟‬What are the main sites of cloudy swelling(٣)

Give three examples of hydropic change(٤)

Define necrosis(٥)

.Describe morphological and ultrastructural changes of necrosis(٦)

.Mention types of necrosis with examples(٧)

.Describe gross and microscopic picture of coagulative necrosis(٨)

‫؟‬What are the associated pathological changes of necrosis(٩)

Define apoptosis(١٠)

Discuss mechanism of apoptosis(١١)

.Mention examples associated with apoptosis(١٢)

.Mention the differences between necrosis and apoptosis(١٣)

.Mention four causes of fatty change(١٤)

Discuss the pathogenesis of fatty change of the liver(١٥)

Mention the gross and microscopic picture of fatty change of the liver(١٦)

.Mention the gross and microscopic picture of the fatty change of the heart(١٧)

.Mention three examples of cholesterol accumulations(١٨)

.Mention four different sites of hyaline change(١٩)

.Mention two conditions associated with fibrinoid change(٢٠)

Mention two conditions associated with extracellular accumulation of mucin (٢١)

.((myxoid change
.Define amyloidosis(٢٢)

.Mention the chemical and clinical classifications of amyloidosis(٢٣)

.Mention sites of primary amyloidosis(٢٤)

.Mention sites of secondary amyloidosis(٢٥)

.Mention the gross appearance of amyloidosis(٢٦)

.Describe microscopic picture of amyloidosis(٢٧)

‫؟‬How can you diagnose amyloidosis(٢٨)

.Mention four effects of amyloidosis(٢٩)

:LONG QUESTIONS
.Discuss causes, pathogenesis and morphology of cloudy swelling(١)

Discuss necrosis; definition, types, morphological changes and associated (٢)

.pathological changes

.Define apoptosis and discuss its pathogenesis and associated conditions (٣)

Discuss causes, pathogenesis, gross and microscopic picture of fatty change of (٤)
.the lives

.Define fibrinoid change and mention associated conditions(٥)

Discuss amyloidosis; definition, classifications, gross and microscopic picture (٦)

.and effects

GRANULOMAS
TUBERCULOSIS

:SHORT QUESTIONS
Define granuloma(١)
.Mention types of granuloma with two examples of each type(٢)
.Describe the proliferative reaction to tubercle bacilli(٣)
.Describe the microscopic picture of tuberculous tubercle(٤)
Methods of spread of tuberculous reaction(٥)
.Mention four cytokines responsible for tuberculous hypersensitivity reaction(٦)
‫؟‬What are the types of primary tuberculous complex(٧)
‫؟‬What are types of pulmonary tuberculosis(٨)
‫؟‬What is the fate of primary pulmonary tuberculosis(٩)
‫؟‬Mention five complications of chronic fibrocaseous tuberculosis of the lung(١٠)
‫؟‬What are the forms of acute progressive pulmonary tuberculosis(١١)
.Describe gross and microscopic picture of tuberculous bronchopneumonia(١٢)
‫؟‬What are gross and microscopic picture of military tuberculosis(١٣)
‫؟‬What are the gross and microscopic pictures of tuberculous lymphadenitis(١٤)
‫؟‬What are the effects of tuberculous lymphadenitis(١٥)
Mention gross and microscopic picture of ulcerative type of tuberculous (١٦)
.enteritis
‫؟‬What are the complications of primary intestinal tuberculosis(١٧)
‫؟‬What are the complications of secondary intestinal tuberculosis(١٨)
.Mention causes of tuberculous peritonitis(١٩)
.Mention the gross appearance of dry type of tuberculous peritonitis(٢٠)
.Define Pott’s disease and mention three complications(٢١)
Describe gross appearance of tuberculous meningitis(٢٢)
.Mention the C.S.F. changes characteristic to tuberculous meningitis(٢٣)
.Describe the gross appearance of tuberculous epididymitis(٢٤)
.Describe the pathological features of tuberculous salpingitis(٢٥)
:LONG QUESTIONS
Give an account on host response to tubercle bacilli(١)
.Discuss primary pulmonary tuberculosis(٢)
.Give an account on secondary pulmonary tuberculosis (٣)
.Discuss acute progressive pulmonary tuberculosis(٤)
.Give an account on tuberculous lymphadenitis(٥)
.Give an account on intestinal tuberculosis(٦)
.Give an account on tuberculous peritonitis(٧)
.Give an account on Pott’s disease(٨)
.Give an account on tuberculous arthritis(٩)
Give an account on tuberculous meningitis(١٠)

SYPHILIS
:SHORT QUESTIONS
Mention sites, gross and microscopic picture of hard chancre(١)
Mention four manifestations of secondary stage of acquired syphilis(٢)
Describe gross appearance of gummatous ulcer of the skin(٣)
.Mention four sites of gumma and its effect(٤)
Describe microscopic picture of syphilitic aortitis(٥)
Mention three complications of syphilitic aortitis(٦)
:LONG QUESTIONS
.Give an account of tertiary stage of acquired syphilis(١)
Give an account on syphilitic aortitis, gross and microscopic picture and (٢)
complications

LEPROSY
:SHORT QUESTIONS
.Mention 4 sites of lepromatous leprosy and is effect(١)
.Mention different types of leprosy and microscopic picture of each one(٢)
RHINOSCLEROMA
:SHORT QUESTIONS
Describe microscopic picture of rhinoscleroma(١)

SARCOIDOSIS
:SHORT QUESTIONS
Describe microscopic picture of sarcoidosis(١)
.Mention 5 pathological lesions due to sarcoidosis(٢)

:LONG QUESTIONS
Give an account on sarcoidosis(١)
ACTINOMYCOSIS,MADURA FOOT
:SHORT QUESTIONS
Describe microscopic picture of actinomycosis(١)
Mention sites of actinomycosis and its effect(٢)
Describe gross and microscopic picture of madura foot(٣)
:LONG QUESTIONS
Give an account on actinomycosis(١)

PARASITIC DISEASES
BILHARZIASIS
:SHORT QUESTIONS
.Describe microscopic picture of bilharzial reaction(١)
Describe gross appearance of bilharzial cystitis(٢)
Describe changes in the epithelial lining of the urinary bladder due to bilharziasis(٣)
Mention 4 complications of bilharzial cystitis(٤)
Mention the gross appearance of bilharziasis of the large intestine and two (٥)
.complications
Describe gross and microscopic picture of bilharziasis of the liver(٦)
Mention three complications of bilharziasis of the liver(٧)
.Mention three effects of portal hypertension(٨)
Mention gross and microscopic picture of bilharzial splenomegaly(٩)
Mention pathological features of bilharziasis of the lung(١٠)
:LONG QUESTIONS
Give an account on bilharzial cystitis(١)
.Give an account on bilharziasis of the large intestine(٢)
Give an account on bilharziasis of the liver(٣)
Give an account on bilharzial splenomegaly(٤)

FILARIASIS ,HYDATID DISEASE, TOXOPLASMOSIS

:SHORT QUESTIONS
.Mention the pathological lesions of filariasis(١)
Describe the microscopic picture of hydatid cyst and mention four complications(٢)
What are the pathological lesions of toxoplasmosis(٣)
ANKYLOSTOMIASIS & ASCARIASIS
:SHORT QUESTIONS
Give four complications of ankylostomiasis(١)
Give four complications of ascariasis(٢)

CIRCULATORY DISTURBANCES
HYPERAEMIA
:SHORT QUESTIONS
.What are the types of venous congestion and mention the cause of each type(١)
Describe gross and microscopic picture of chronic venous congestion of the (٢)
liver
Describe gross and microscopic picture of chronic venous congestion of the (٣)
lung
Describe gross and microscopic picture of chronic venous congestion of the (٤)
spleen
:LONG QUESTION
Discuss systemic venous congestion (chronic venous congestion); clinical (١)
.features and structural changes in organs
THROMBOSIS
:SHORT QUESTIONS
Mention four differences between thrombus and clot(١)
‫؟‬What are the predisposing factors of thrombosis(٢)
(Mention fate of thrombi (four examples(٣)
.Define phlebothrombosis and mention its causes(٤)
.Define thrombophlebitis and mention its causes and effects(٥)
:LONG QUESTION
Give an account on thrombosis; types of thrombi, predisposing factors, (١)
pathogenesis, sits and fat of thrombi

EMBOLISM
:SHORT QUESTIONS
Define embolism and mention 4 types of emboli with and example of each one(١)
:LONG QUESTION
Give an account on embolism(١)
ISCHAEMIA
:SHORT QUESTIONS
.What are types of local ischaemia; mention causes and effects of each one(١)

INFARCTION
:SHORT QUESTIONS
Define infarction and mention gross and microscopic picture of infarction of (١)
kidney
Define infarction and mention gross and microscopic picture of infarction of (٢)
.spleen
Define infarction and mention gross and microscopic picture of infarction of lung(٣)
:LONG QUESTION
Give an account on infarction and discuss in detail infarction of kidney, lung and (١)
.brain
OEDEMA
:SHORT QUESTIONS
Mention four causes of oedema(١)
‫؟‬What are the causes of localized oedema(٢)
‫؟‬What are the types of generalized oedema(٣)
‫؟‬What are the causes of renal oedema(٤)
‫؟‬What are the differences between transudate and exudate(٥)
:LONG QUESTION
Give an account on generalized oedema(١)
GANGRENE
:SHORT QUESTIONS
.Define gangrene and mention its types(١)
Mention stages of dry gangrene of the leg(٢)
.Mention causes and pathological features of wet gangrene of the lower limb(٣)
Mention causes and pathological features of wet gangrene of the intestine(٤)
Mention causes and pathological features of wet gangrene of the lung (٥)
Mention causes and pathological features of gas gangrene (٦)
. Give 5 differences between dry and wet gangrene(٧)

:LONG QUESTION
Discuss dry gangrene of the leg(١)
Mention sites of wet gangrene and discuss wet gangrene of lower limb(٢)

HAEMORRHAGE
:SHORT QUESTIONS
Give four different causes of haemorrhage(١)
..………… ………………………………………Haemothorax means(٢)
…………… ………………………………………Haemoarthrosis means(٣)
What are effects of hemorrhage(٤)

SHOCK
:SHORT QUESTIONS
.What are types of shock and give a cause of each one(١)

PATHOLOGICAL CALCIFICATION
:SHORT QUESTIONS
.Define dystrophic calcification and mention sites with examples(١)
Define metastatic calcification and mention its sites (٢)
:LONG QUESTIONS
.Give an account on pathological calcification(١)
DISORDERS OF BODY PIGMENTATION
:SHORT QUESTIONS
Give three examples of excessive melanin pigmentation(١)
.Give three examples of diminished melanin pigmentation(٢)
.Define haemosiderosis , mention its types and give two examples of each one(٣)
.Define haemochromatosis and mention characteristics of the primary one(٤)
Mention the cause and describe gross picture of brown atrophy of the heart(٥)

DISORDERS OF CELLULAR GROWTH

:SHROT QUESTIONS
Define atrophy and mention four different causes(١)
Define hyperplasia and mention four different causes with examples(٢)
.Define hypertrophy and mention three examples(٣)
.Define metaplasia, mention its types with examples(٤)
.Define dysplasia and mention its sits and cytological features(٥)
Define carcinoma in situ(٦)
:LONG QUESTIONS
Give an account on atrophy(١)
Give an account on hyperplasia (٢)
Give an account on metaplasia (٣)
Give an account on dysplasia(٤)

TUMOURS
:SHORT QUESTIONS
.Define locally malignant tumours with examples(١)
.Give five differences between benign and malignant tumours(٢)
.Mention methods of spread of malignant tumours(٣)
.Mention mechanisms of local spread of malignant tumours and its effect(٤)
Mention six differences between sarcoma and carcinoma(٥)
.Mention sites, gross and microscopic features of squamous cell papilloma(٦)
.Define adenoma and mention its gross and microscopic features(٧)
.Mention sites,gross and microscopic features of squamous cell carcinoma(٨)
Mention sites, gross and microscopic features of basal cell carcinoma (٩)
.Define adenocarcinoma and mention sites, gross and microscopic picture(١٠)
.Mention, sites, gross and microscopic picture of lipoma(١١)
.Mention, sites, gross and microscopic picture of liposarcoma (١٢)
Mention sites, gross and microscopic picture of capillary haemangioma(١٣)
Mention sites, gross and microscopic picture of cavernous haemangioma(١٤)
Mention sites, gross and microscopic picture of cavernous lymphangioma(١٥)
.Define leiomyoma and mention its sites, gross and microscopic picture(١٦)
.Define leiomyosarcoma and mention its sites, gross and microscopic features(١٧)
.Define naevus and mention its sites, gross and microscopic types(١٨)
.Define teratoma and mention its sites and classification(١٩)
.Mention gross and microscopic features of mature cystic teratoma(٢٠)
.Define embryomas and give four examples(٢١)
.Define hamartomas and give examples(٢٢)
.Mention three viruses of carcinogenic effect(٢٣)
.Define oncogenes and two mechanisms of its formation(٢٤)
.Mention five laboratory methods for diagnosis of cancer (٢٥)
. Define paraneoplastic syndromes and mention two of them(٢٦)
:LONG QUESTIONS
.Mention the differences between benign and malignant tumours(١)
.Discuss methods of spread of malignant tumours(٢)
.Mention differences between carcinoma and sarcoma(٣)
.Give an account on benign epithelial tumours(٤)
.Mention factors which may activate cellular oncogenes(٥)

Questions on Granulomas, Parasitic Diseases & Circulatory

Disturbances

:Infrarenal aortic aneurysm may be complicated by .١

Pulmonary thromboembolism *
Renal embolism & infarction *
Lower limb embolism & ischemia *
Oedema of legs *

Pathologic lesions produced by chronic venous congestion include all the .٢

:following except

a) Nutmeg liver b) Brown induration of the lung

c) Splenic Gamma Gandy nodules d) Red swollen leg in cellulitis

‫؟‬Active hyperemia is present in which of the following conditions .٣

a)A 37 year old male who develops massive scrotal swelling due to infection with
Wucheria bancrofti

b)A 6 year old boy who develops sudden onset of intense scrotal pain due to
testicular torsion

c)A 69 year old male who dies due to progressive congestive heart failure and the
liver showed a nutmeg cut surface

d) A 19 year old medical student who develops a red face after being asked a
!!question in the lecture
A 45 year old dentist works in a clinic notices at the end of the day that her legs & .٤
feet were swollen, although there was no swelling at the beginning of the day. There
was no pain or redness. The liver & renal function tests were normal. Which of the
‫؟‬following mechanisms that best explains this case

a) Increased hydrostatic pressure b) Lymphatic obstruction

c) Hypoproteinemia d) Inflammation of subcutaneous tissue

A 78 year old man had fracture neck femur. He was hospitalized and undergone .٥
hip replacement. Two weeks later his legs were swollen, painful on movement and
tender. Which of the following complications is most likely to occur after these
‫؟‬events

a) Gangrenous necrosis of the foot b) Haematoma of the thigh

c) Pulmonary thromboembolism d) Fat embolism

About 10 months after returning from a tropical country, a 45 year old man .٦
experiences malaise, fatigue, low grade fever, abdominal discomfort. On physical
examination, he had hepatosplenomegaly and generalized lymphadenopathy with
hyperpigmentation of the skin of the extremities. Laboratory investigations revealed
pancytopenia. Stool analysis was negative for occult blood. Which of the following
: ‫؟‬is the most likely diagnosis

a) Echinococcosis b) Leishmaniasis

c) Schistosomiasis d) Tuberculosis

A 40 year old man complained of progressive enlargement of his leg for the last 6 .٧
years that had an elephantoid appearance. On examination he had enlarged
inguinal lymph nodes with scrotal oedema. Which of the following organism is most
‫؟‬likely to present

a) Leishmania tropica b) Echinococcus granulosis

c) Enterobius vermicularis d) Wucheraria bancrofti

A 60 year old woman had a fever and a cough productive of yellow sputum. Chest .٨
x ray revealed areas of consolidation in the lower lobe of the left lung. The
condition was complicated by abscess formation with bronchopleural fistula.
Biopsy shows small yellow sulphur granules. Which of the following organisms is
: ‫؟‬the most likely to produce these findings

a) Actinomyces Israeli b) Mycobacterium tuberculosis c) Klebsiella

rhinoscleromatis d) Leishmania donovani

:Oedema in renal failure is due to .٩

a) Lymphatic obstruction b) Decreased osmotic pressure

c) Increased vascular permeability d) Increased hydrostatic pressure

:Disorders that predispose to thrombosis include all the following except .١٠

a) Thrombocytopenia b) Pancreatic carcinoma c) Amniotic fluid infusion d) Severe

burns

:Red infarcts are usually found in all the following except .١١

a) Pulmonary embolism

b) Torsion of testis

c) Superior mesenteric artery embolism

d) Coronary artery thrombosis

Multiple Choice Questions on Disturbance of Growth &

Neoplasia
Presented by Dr. Faten Ghazal

A small part of left lobe of liver was removed after an injury. Several weeks later (١
the liver regains its size as shown by CT. Which of the following process explains
‫؟‬this finding

Apoptosis *
Dysplasia *
Hyperplasia *
Metaplasia *
Cancers that occur in tissues that have undergone metaplasia then become (٢
:dysplastic and finally become malignant include

Squamous cell carcinoma of the endocervix *

Squamous cell carcinoma of the bladder *
Bronchogenic squamous cell carcinoma *
Adenocarcinoma of the esophagus *

a: 1,2,3 b: 1,3 c: 2,4 d: 4 only e: all

A 32-year-old woman had a pelvic mass. An abdominal ultrasound reveals an 8 (٣

cm right ovarian cystic mass. The mass is surgically excised. On gross inspection
and sectioning, the surface of the mass is smooth, is not adherent to surrounding
pelvic structure, and is filled with hair and sebaceous material. On microscopic
examination there is squamous epithelium, tall columnar glandular epithelium,
cartilage, and fibrous connective tissue. Which of the following neoplasms is she
‫؟‬most likely to have

Choristoma *
Hamartoma *
Myxoma *
Teratoma *

:Grading of tumours depends on the following except (٤

Degree of anaplasia *
Metastatic spread *
No. of mitotic figures *
Degree of differentiation *

:Factors that are assessed in the staging of a malignant tumour include except (٥

Numbers of lymph nodes containing metastases *

Size of the primary tumour *
Degree of local invasion of the primary tumour *
Number of mitoses in the primary tumour *

:The best description of an invasive adenocarcinoma of the colon is (٦

A disorganized masses of cells forming keratin *

A disorganized masses of cells forming glandular structures *
A uniform proliferation of glandular structures *
A uniform proliferation of cells forming keratin *
A study is performed to analyze characteristics of malignant neoplasms in (٧
biopsy specimens. Of the following microscopic findings, which is most likely to
‫؟‬indicate that the neoplasm is malignant

Pleomorphism *
Atypia *
Invasion *
Increased nuclear/cytoplasmic ratio *

A 45-year-old woman has noted a lump on her left shoulder that has enlarged (٨
over the past 4 months. On physical examination there is an enlarged, non-tender
supraclavicular lymph node. A biopsy of the node is done and on microscopic
examination there is a metastatic neoplasm. Which of the following is the most
‫؟‬likely primary neoplasm

Adenocarcinoma of the colon *

Fibroadenoma of the breast *
Liposarcoma of the retroperitoneum *
Laryngeal papilloma *

It is observed that some neoplasms appear to develop from viral oncogenesis, (٩

with serologic confirmation of past viral infection. Which of the following
‫؟‬neoplasms is most likely to arise in this manner

Retinoblastoma *
T-cell leukemia *
Prostatic adenocarcinoma *
Hepatic angiosarcoma *

Some pre-existing conditions are observed to precede development of (١٠

malignant neoplasms, while others do not. Which of the following conditions is
‫؟‬most likely to be statistically unrelated to subsequent malignancy

Endometrial atypical hyperplasia *

Chronic alcoholism with hepatic cirrhosis *
Cervical squamous dysplasia *
Chronic ulcerative colitis *
Uterine leiomyoma *
A 62-year-old man has complained of pain on urination for the past week. He is .١١
afebrile. On cystoscopy, a slightly erythematous 1 cm diameter area is seen on the
bladder mucosa. This area is biopsied and on microscopic examination shows cells
with marked hyperchromatism, pleomorphism and increased nuclear/cytoplasmic
ratio involving the full thickness of the epithelium. Which of the following terms
‫؟‬best describes these biopsy findings

Metaplasia *
Minimal dysplasia *
Microinvasion *
Hyperplasia *
Carcinoma in situ *

A 50-year-old woman had a 2 cm firm mass in her left breast. Fine needle .١٢
aspiration biopsy is performed & was diagnosed as a ductal carcinoma. A poorer
prognosis for the patient is most closely associated with which of the following
‫؟‬findings

Aneuploidy by flow cytometry *

Positive immunohistochemical staining for estrogen receptor *
A well-differentiated histologic appearance *
Intraductal growth pattern *
Stage of T1 N0 M0 *

For a 40 year old woman, a chest x-ray was taken and shows a peripheral 2.5 cm .١٣
diameter "coin lesion" in the right mid-lung field. Which of the following biologic
characteristics best distinguishes (diagnoses) this lesion as a neoplasm, & not a
‫؟‬granuloma

Recurrence following excision *

Rapid increase in size *
Uncontrolled (autonomous) growth *
Necrosis *

The liver of a 55-year-old man contains multipletumor masses from 2 to 5 cm in .١٤

size that are firm and tan exhibiting umbilication with central necrosis. Which of the
following statements would best characterize the significance of such an
‫؟‬appearance

.There is multicentric origin of a benign neoplasm *

.The neoplasm has a high grade *
.A carcinogen was the underlying cause for the neoplasm *
The neoplasm has an advanced stage *
A 44-year-old woman notes a lump in her left breast 3 cm firm, irregular, non- .١٥
movable located in the upper outer quadrant. A fine needle aspiration revealed
infiltrating ductal carcinoma. The mass is removed with lumpectomy along with an
axillary lymph node dissection. Which of the following findings will best predict a
‫؟‬better prognosis

The tumor cells are strongly estrogen receptor positive *

No metastases are found in the sampled lymph nodes *
She has one relative who had a similar type of breast cancer *
The tumor has a high grade *

A 22-year-old woman had a palpable nodule in the right lobe of her thyroid .١٦
gland. It was diagnosed as a papillary carcinoma of the thyroid. No cervical lymph
node metastases & no distant metastases. Which of the following findings would
you consider most relevant in her past history to indicate a risk factor for this
‫؟‬neoplasm

Chronic alcoholism *
Radiation therapy in childhood *
Blunt trauma from a fall *
Exposure to arsenic compounds *

The most important feature in differentiating a malignant from a benign tumour .١٧
:is

a) Lack of encapsulation b) Presence of mitotic figures

c) Presence of metastases d) Nuclear pleomorphism

Which of the following features that favours a diagnosis of lipoma rather than .١٨
‫؟‬normal adipose tissue

a) Anaplasia b) Uniform population of cells

c) Numerous mitosis d) Fibrous capsule

If a hypertensive patient remains untreated for years, which of the following .١٩
‫؟‬cellular alteration will be seen in the myocardium

a) Atrophy b) Hyperplasia c) Hemosiderosis d) Hypertrophy e) Metaplasia

:The decrease in the size of an immobilized leg in a cast is due to .٢٠

a) Aplasia b) Atrophy c) Agenesis d) Hypoplasia

:The increase in size of the uterus of a pregnant woman is due to .٢١

a) Endometrial glandular hyperplasia b) Myometrial fibroblast proliferation

c) Endometrial stromal hypertrophy d) Myometrial smooth muscle hypertrophy

A 60 year old woman had vaginal bleeding. On examination an ovarian mass .٢٢
was found. Abdominal hysterectomy was done. Microscopically the ovarian tumour
was a granulosa theca cell tumor that secretes oestrogen. The uterus showed
endometrial carcinoma. Which of the following best describes the relationship of
‫؟‬the 2 tumours

a) Paraneoplastic syndrome b) Promotion of carcinogenesis

c) Mutation of a tumour suppressor gene d) Genetic susceptibility to tumorigenesis

Multiple Choice Questions on Diseases of Respiratory System

((07-08

A 60 year old man, heavy smoker had persistent cough over the past 6 months. .١
Chest x ray revealed a cavitary lung lesion near the right hilum. His laboratory
findings were normal except for evidence of hypercalcaemia. Bronchoscopy
revealed a right bronchial mass obliterating its lumen. What is the possible
‫؟‬diagnosis

Bronchioalveolar carcinoma *
Adenocarcinoma *
Squamous cell carcinoma *
Hamartoma *
A 45 year old man had an increasing cough with haemoptysis for 2 weeks. He .٢
was feverish. Chest x ray revealed an area of consolidation in the right upper lobe.
After antibiotic therapy his fever improved but the cough and haemoptysis did not
improve. Repeated chest x ray revealed right upper lobe collapse.obstructing well
circumscribed massdiagnosis? Bronchoscopic examination revealed an arising
from the main bronchus. Which of the following tumour is the most likely the

Carcinoid Tumour *
Hamartoma *
Adenocarcinoma *
Large cell carcinoma *

A 50 year old man complained of progressive dyspnea first on exertion then now .٣
even at rest. He had no fever. The chest x ray revealed interstitial linear opacities.
The pulmonary function tests showed a restrictive lung disease. Which of the
‫؟‬following sets of pathological changes is the most likely to be found in his lungs

.Chronic inflammation of bronchial walls with prominent eosinophilic infiltrate *

Chronic inflammation of bronchial walls with hyperplasia & hypertrophy of *
.mucus glands
.Uniform dilatation of airspaces distal to respiratory bronchiole *
.Honey comb lung with widespread alveolar septal fibrosis *

On routine chest x ray for a 45 year old man , revealed a 3cm. well circumscribed .٤
opaque peripheral mass. A wedge resection of the lobe was done. The gross
description of the pathologist was a well circumscribed mass having greyish white
‫؟‬gelatinous glistening lobulated cut surface with few clefts. What is your diagnosis

Adenocarcinoma *
Bronchioalveolar carcinoma *
Hamartoma *
Squamous cell carcinoma *

A 68 year old female had shortness of breath that was more severe in the last 2 .٥
months. She was afebrile. Chest x ray revealed bilateral pleural effusion. Aspiration
of the pleural effusion was done and the fluid was clear slightly yellow tinged (straw
‫؟‬coloured). Which of the following is the most probable the cause of these findings

Metastatic adenocarcinoma *
Congestive heart failure *
Mediastinal lymphoma *
Pneumonia *
A 40 year old woman had suffered from multiple attacks of necrotizing .٦
pneumonia. She now has a productive cough of large amount of purulent sputum.
The chest x ray suggested dilatation of right lower lobe bronchi. Which of the
‫؟‬following mechanisms is the cause of bronchial dilatation

Unopposed action of neutrophil derived elastase *

Congenital weakness of supporting structures of the bronchial wall *
Destruction of bronchial walls by recurrent inflammation *
Damage to bronchial mucosa by inflammatory mediators released from *
eosinophils

A 60 year old man is a smoker with a 10 year history of cough productive of .٧

copious mucopurulent sputum. Over the past 6 months he has developed
progressive dyspnea. Physical examination showed lower limb oedema and an
enlarged soft liver. Chest x ray showed bilateral pleural effusion and an enlarged
heart. The patient was put on a ventilator and died 6 days later. Which of the
following microscopic findings is most likely to be characteristic of his underlying
‫؟‬lung disease

Infiltrates of eosinophils in bronchial wall *

Extensive interstitial fibrosis *
Carcinoma filling the lymphatic spaces *
Hypertrophy of bronchial submucosal glands *

A man worked in a shipyard for 20 years. He complained of progressive dyspnea. .٨

Chest x ray revealed a mass ensheathing the left lung. Within the lung parenchyma
adjacent to the mass many golden brown beaded rods and fusiform bodies are
‫؟‬seen. Which of the following is the possible chest x ray findings

Left upper cavitary lesion *

Diaphragmatic pleural calcified plaques *
Left lower lobe bronchial dilatation *
Left lower lobe consolidation *

A 11 year old boy complained of cough, wheezes and difficulty in breathing. The .٩
attacks are common in spring. During the attack, he is afebrile. The lungs are hyper
resonant (increased air). Laboratory findings showed high IgE level and
eosinophils. The sputum examination showed also increased number of
eosinophils. Which of the following histological features are characteristic for this
‫؟‬patient’s acute condition

Dilatation of the respiratory bronchiole and distention of alveoli *

Dilatation of the bronchi with inflammatory destruction of the walls *
Thickening of bronchial epithelial basement membrane by collagen and *
hypertrophy of smooth muscle
Patchy areas of consolidation surrounding the bronchioles with neutrophilic *
infiltrate in affected alveoli

A 6 year old girl had cough, headache and fever .She also suffered from .١٠
respiratory difficulty for 5 days. Respiratory syncytial virus was isolated from the
sputum sample. Which of the following chest x ray findings is most likely to be
‫؟‬present

Lobar consolidation *
Interstitial infiltrate *
Upper lobe cavitation *
A peripheral mass *

A 8 year old boy has accidently aspirated one of the peanuts while he was .١١
eating. One day later, he developed slight dyspnea. A chest CT was done and
revealed a hemicircular area of density in the right lower lobe. He had normal blood
‫؟‬picture and had no fever. What is the possible diagnosis

Bronchiectasis *
Lung abscess *
Pneumthorax *
Lung lobe collapse *

A 55 year old man had gradual increasing dyspnea. He is heavy smoker. He had .١٢
a barrel shaped chest. His chest x ray revealed a bilateral hyperinflation of lungs
more in the upper lobes. Which of the following points contributes in the
‫؟‬pathogenesis of his lung disease

Release of elastase from the neutrophils *

Impaired hepatic formation of alpha1 antitrypsin *
Decreased ciliary motility *
Recruitment of eosinophil in bronchial mucosa *

A 65 year old woman complained of pain in her right arm and forearm. On .١٣
examination she had as well ptosis, meiosis and enophthalmos on her right eye.
Chest x ray was done for her and revealed right upper lobe opacity. What is your
‫؟‬diagnosis

Suppurative bronchopneumonia *
Tuberculous bronchopneumonia *
Bronchogenic carcinoma *
Hamartoma *
A patient working in sandblasting business for 20 years complained of cough .١٤
and increasing dyspnea with no fever or sputum production. Which of the following
‫؟‬cells are responsible for the pathogenesis of his disease

Eosinophils *
Mast cells *
Macrophages *
Neutrophils *

A 50 year old man , heavy smoker complained of persistent nonproductive .١٥

cough observed gain of weight especially in the trunk over the past 5 months . The
chest x ray shows an ill defined 3 cm mass involving the right hilum of the lung.
Cytological examination of the bronchial washings from bronchoscopy revealed
round to oval cells with little cytoplasm and increased mitotic figures. He was
advised to stop smoking and begin a course of chemotherapy. Which is the
‫؟‬possible diagnosis

Adenocarcinoma *
Large cell carcinoma *
Squamous cell carcinoma *
Small cell carcinoma *

:Bronchioalveolar carcinoma is characterized by the following except .١٦

It doesn't destroy the alveolar wall *

It mimics bronchopneumonia on chest x ray *
It is formed of small to oval sheets of cells having high number of mitotic *
figures
It has a better prognosis than other lung cancers *

:Cigarette smoke contributes in the pathogenesis of emphysema by all except .١٧

Attracts neutrophils into the lung *

Stimulates the release of neutrophil elastase *
Inhibits the ability of pulmonary neutrophils to clear bacteria *
Directly inhbits alpha 1 antiyrypsin *
Stimulates macrophage elastase activity *
:The following statements are correct for mesothelioma except. .١٨

It may resemble an adenocarcinoma histologically *

It may resemble sarcoma histologically *
It is related to asbestos exposure *
It is related to cigarette smoke *

A 23 year old man had difficulty in breathing through his nose for 2 years. .١٩
Examination showed glistening semitransluscent polypoid masses filling the nasal
cavity. Microscopic examination of the excised masses revealed polypoid tissue
covered by respiratory epithelium with underlying oedematous stroma heavily
infiltrated by acute & chronic inflammatory cells with scattered plasma cells &
: eosinophils. The possible associated condition is

a) Infection by corynaebacterium Diphtheriae

b) Increased serum Ig E level

c) Infection by papilloma virus

d) Fever,chills& enlarged painful cervical lymph nodes

A 70 year old man complained of persistent hoarseness of voice for the last 6 .٢٠
months. On examination there was an enlarged nontender anterior cervical lymph
node. On laryngoscopy an irregular fungating mass was seen on the vocal cord
with infraglottic extension. Laryngeal biopsy followed by laryngectomy was done.
Which of the following etiologic factors most likely played the greatest role in the
:‫؟‬development of this lesion

a) Human Papilloma virus

b) Type I Hypersensitivity

c) Smoking Tobacco

d) Corynaebacterium Diphtheria
Over the last 3 months , a 6 year old boy had difficulty in breathing with .٢١
changing in the character of his voice. On examination multiple masses were seen
on the vocal cords extending to the subglottic region. Microscopic examination of
the excised masses showed fingerlike polypoid tissue covered by orderly arranged
stratified squamous epithelium overlying a fibrovascular connective tissue core.
:‫؟‬Which of the following statements is the best advice to his parents

a)Laryngectomy is necessary

b)The boy should not overuse his voice

c)The lesions are likey to recur

d)Poststreptococcal glomerulonehritis may follow

An active primary stage school teacher had noticed that her voice had changed .٢٢
for the past 3 years. On examination there were no palpable head & neck masses
but there were two tiny hemispherical smooth surfaced masses about few
millimeters in diameter seen on both vocal cords. The teacher was unfortunatelya
smoker. Excisional biopsy was recommended by her otolaryngologist because the
:most likely diagnosis was

a)Laryngeal Polyp

b)Juvenile Papillomatosis

c)Squamous cell Papilloma

d)Squamous cell Carcinoma